"is avoidant personality disorder CHARACTERIZED by stability or instability? a study of mode fluctuation in the course of schema therapy sessions"

hot topic by ofer peled & eshkol rafaeli

SUMMARY:

APD is among the most prevalent personality
disorders, but has received little empirical attention. This study characterize
mode change patterns among APD clients in the course of ST. A newly-developed
client mode rating scale was used to code every 5-minute segment of 60 ST
sessions from 15 clients. The avoidant/detached mode was present in 3/4 of
segments and was the most intense and fluctuating mode. Its great fluctuation
implies that therapists can crack this coping mode and gain access to the
clients' emotional needs. The over-compensator & compliant-surrenderer modes
were less prominent (present only in 1/3 of segments); this implies that
therapists can primarily focus on overcoming avoidance & detachment,
implementing strategies for overcoming dependence or self-absorption less
frequently. The vulnerable child mode was present in more than half of segments
and was the second most intense and unstable mode. The presence of this mode
provides a possible access point for corrective therapeutic experiences, but
its instability may block the chances for healing emotional pain. The
dysfunctional parent mode was present in less than 1/2 of segments, but was the
third most intense and unstable mode. In contrast, the healthy adult mode,
present in 1/3 of segments, was by far the most stable. It seems that APD
clients were more prone to self-punitive criticism than to self-compassion.
This study offers 4 innovations: (a) It
documents the considerable instability of APD, using
mean-square-successive-difference (MSSD) scores; (b) It offers rich data on the
mode-based description of APD and its possible implications for intervention; (c)
It demonstrates the utility of the mode concept as a lexicon for capturing
personality states and their instability; and (d) It illustrates the use of
in-session segment-by-segment ratings to assess client change within psychotherapy.

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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